00702 Anesthesia for procedures on upper anterior abdominal wall; percutaneous liver biopsy

Name of the Procedure:

Anesthesia for procedures on the upper anterior abdominal wall; percutaneous liver biopsy

Summary

This procedure involves administering anesthesia to numb the upper front part of the abdomen, allowing for a liver biopsy to be performed through the skin with minimal discomfort.

Purpose

The procedure aims to diagnose liver conditions, such as hepatitis, cirrhosis, or liver tumors, by obtaining a small tissue sample from the liver. The anesthesia ensures the patient is comfortable during the biopsy, reducing pain and anxiety.

Indications

• Unexplained liver abnormalities from blood tests or imaging studies
• Monitoring progress of liver disease
• Evaluating the effectiveness of liver disease treatment
• Patients with symptoms like jaundice, unexplained weight loss, or abdominal pain related to liver issues

Preparation

• Patients may need to fast for several hours before the procedure.
• Blood tests to check clotting function and overall health status.
• Adjustments to medications, especially blood thinners, as advised by the physician.

Procedure Description

1. The patient is positioned comfortably on their back or side.
2. The skin over the biopsy site is cleaned and sterilized.
3. Local anesthesia is injected to numb the area.
4. Using ultrasound or CT guidance, a needle is inserted through the skin into the liver to collect a tissue sample.
5. The needle is removed, and pressure is applied to prevent bleeding.
6. A small bandage is placed over the biopsy site.

Duration

The entire procedure typically takes about 30 to 60 minutes, including preparation and recovery time.

Setting

This procedure is usually performed in a hospital or an outpatient clinic equipped with imaging facilities.

Personnel

• Anesthesiologist or nurse anesthetist
• Radiologist or gastroenterologist
• Nursing staff

Risks and Complications

• Minor: Pain at the biopsy site
• Moderate: Bleeding or hematoma formation
• Rare: Infection, injury to surrounding organs such as the gallbladder or lungs

Benefits

• Minimally invasive way to diagnose liver conditions
• Provides essential information for proper treatment planning
• Rapid recovery and minimal post-procedure discomfort

Recovery

• Patients are typically observed for a few hours post-procedure for any signs of complications.
• Instructions may include rest, avoiding heavy lifting, and watching for signs of infection or excessive bleeding.
• Most patients can resume normal activities within 24 to 48 hours.
• Follow-up appointments may be scheduled to discuss biopsy results.

Alternatives

• Non-invasive imaging tests (ultrasound, MRI, CT scans)
• Blood tests, though they may not provide as detailed information as a biopsy
• Each alternative has its own pros and cons, such as less detail with imaging or incomplete diagnostic information from blood tests.

Patient Experience

During the procedure, the patient may feel slight pressure or discomfort when the anesthesia is administered and when the biopsy needle is inserted. Post-procedure, there might be mild soreness which can be managed with over-the-counter pain relievers. Most patients are able to return home the same day.